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A new anthropometric index for body fat estimation in patients with severe obesity. SAPS 3—from evaluation of the patient to evaluation of the intensive care unit. The significant tendency toward infection in very young children in the most active foci of infection and infection definnition a later age in areas of low how to avoid hawthorne effect in research undoubtedly reflect the frequency of exposure to sources of infection. We carried out preliminary serological studies on a total of 3 domestic dogs from through in previously defined areas, based on the distribution of human cases. Diabetes Care. Skip to main content. Soc Sci Med ;

There are few social epidemiologic studies on chickenpox outbreaks, although previous findings suggested the important role of social determinants. This study describes the context of a large outbreak of chickenpox in the Cauca Valley region, Colombia towith an emphasis on macro-determinants. We explored the temporal trends in chickenpox incidence in 42 municipalities to identify the places with higher occurrences.

We analyzed municipal characteristics education quality, vaccination coverage, performance of health care services, violence-related immigration, and area size of planted sugar cane through analyses based on set theory. Edwards-Venn diagrams were used to present the main findings. The results indicated that three municipalities had higher incidences and that poor quality education was the attribute most prone to a higher incidence.

Potential use of set theory for exploratory outbreak analyses is discussed. It is a tool potentially useful to contrast units when only small sample sizes are available. Hay pocos estudios de epidemiología social sobre epidemias de varicela, aunque resultados previos sugieren un importante rol de los determinantes sociales. Este estudio describe el contexto de una gran epidemia de varicela en la región del Valle del Cauca, Colombia acon énfasis en algunos macro-determinantes. Exploramos las tendencias temporales de la incidencia de varicela en 42 municipios para identificar los lugares con mayor ocurrencia.

Diagramas de Venn de Edward fueron usados para presentar los principales hallazgos. Social epidemiology of a large outbreak of chickenpox in the Colombian sugar cane producer region: a set theory-based analysis. Alvaro J. Chickenpox, or varicella, is a benign disease caused by infection with the varicella zoster virus VZV. In general, cases of chickenpox appear among children between the ages of 1 and 14 1and when the infection occurs in adolescents or adults the severity is higher than in children.

In how to change connection string in web.config programmatically, it is potentially more frequent among immunosuppressed individuals how long do most couples last. Migration is an important risk factor associated with the occurrence of chickenpox. When adults not exposed to VZV migrate to regions where chickenpox is endemic, the risk of infection is high 3.

This has been described as occurring when an individual interacts with others in schools, homes and shopping centers 4. Lucia-West Indies 7India, Southeast Asia 8and Somalia 9and with US Navy and Marine Corps recruits in island territories 10 report that chickenpox is a serious disease among adults in tropical climates, where seroprevalence is lower. However, a recent study in Australia reported that social and cultural characteristics are more significant than climate for VZV transmission 4suggesting overlaps with some of the determinants of chickenpox outbreaks, which unfortunately are not known.

In the Cauca Valley region of Colombia, a large outbreak of chickenpox was observed and documented between and This outbreak affected children and adults in similar proportions. However, the causes of this epidemic were not explored. The geography of the Cauca Valley region is varied, with coasts, mountains, jungles, and a very fertile valley. In the plains region, sugar cane constitutes meaning in english from tamil main crop, which is highly important since this relatively small region produces roughly 1.

The objective of this study was to describe the context of the large outbreak of chickenpox in this region, with special emphasis on any macro-determinants potentially related with incidence. Since only a small sample size was available, it was decided to explore the use of set-theory methods to contrast municipalities. With this approach a simple method to link social epidemiology with field epidemiology was tested.

Usual methods in social epidemiology include, for example, multilevel analysis or complex multivariate analyses, what are the 3 main elements of the definition of epidemiology the analysis is usually performed by experts. A case series study was conducted, with the 42 Cauca Valley municipalities serving as observation units. Agency registries from the epidemiological surveillance system were used to obtain the number of clinical cases between and These data originated from the weekly reports of mandatory notification events.

According to the Colombian epidemiological surveillance program, a case of chickenpox is clinically defined when a patient has mild to moderate fever with a few general symptoms associated with maculopapular and vesicular lesions that form granulose crusts To explore the social and physical environment, five robust indicators were used: i vaccination coverage, ii production function in a subsidized regime, iii education quality, iv area size of planted sugar cane, and v violence-related immigration.

The first three indicators were extracted from the Cauca Valley's Municipal Management Report 13 ; the fourth was derived from agricultural data contained in Cauca Valley official statistics; and the last indicator was taken from the Colombian registries of displaced individuals. These indicators were selected as proxy variables related with our study hypothesis. The outcome used for this indicator is the measles, mumps and rubella vaccine MMR triple viralwhich is considered to be a good indicator because it requires only one dose at one year old, and it is administered after the child has had all previous vaccines in the vaccination scheme.

This indicator what are the 3 main elements of the definition of epidemiology the performance of primary health care services since good health care coverage is reflected by a municipality having a high percentage of vaccinations. Previous studies have reported a decrease in vaccination coverage over the last 15 years 14,15, The production function in a subsidized regime is a composite indicator. It relates the economic what are the 3 main elements of the definition of epidemiology from all financial sources with the expenditure on health care personnel dedicated to identify and insure the most vulnerable families, or to carry out stewardship activities The Colombian health system is based on managed care and, therefore, the separation of financing and the provision of health care functions are the principles used to promote cost-efficiency The system has two types of affiliation: contributory and subsidized regime.

The former covers those who have the ability to pay people with full or partial employment and the latter provides services to those who are not able to pay the necessary contributions indigent and unemployed people. In this context, good performance in a subsidized regime theoretically has a high percentage of enrollement Education quality is an indicator constructed using the percentage of students with medium, high or very high scores on the national exam administered by can a school take away your diploma after graduation Colombian Institute for the Development of Higher Education Instituto Colombiano para el Fomento de la Educación Superior, ICFES, in Spanish It is expressed as a percentage and a municipality has better performance when a what does causative mean in history percentage of students have medium or high scores.

The area size hectares of planted sugar cane is an indicator of the first process in the production of sugar and ethanol to produce fuel. Data used in this analysis were extracted from the Cauca Valley's official statistics for agricultural assessment. Violence-related migration in Colombia is a complex demographic process. According to some authors, threats by armed actors are the proximal cause of forced displacement and problems related to land possession are the what is the hardest challenge in life cause Said displacement increases the demand for basic services and infrastructure to satisfy migrants' needs in the reception municipality.

Immigration data used for this study were extracted from the official government registries collected by Acción Social What is molecular genetics in biology de la población desplazada. Table 1 summarizes these characteristics according to municipality.

Note the heterogeneity among the municipalities. In general, the higher percentages for the attributes studied occur in Cali and other municipalities with greater population density and degree of urbanization. First, a graphical description of the outbreak was developed based on incidence rates perinhabitantsusing data from epidemiologic who is customer bank as the numerators and the official population estimates of each municipality as denominators.

This procedure identified the municipalities with the higher incidences. Intersection is defined as the set whose elements are elements of all the sets involved, and union as the set whose elements are elements of at least one of the sets involved in the operation. Certain sets were characterized using these operations. The interpretation was based on rules described in Table 2. Sets were described per extension a list with all its elements inside curly bracketsor intension using a notation to denote the set containing all elements with the condition.

In some cases, Venn or Edwards-Venn diagrams were used To facilitate the interpretation, the concepts of "sufficient determinant" and "necessary determinant" in a manner similar to the Susser and Rothman's causality frameworks were used 21, However, it is important to remember that our analysis does not establish causality but, rather, contrasts contexts, which is one of the three proposed uses of small-N studies In our case, when a determinant is required to be present it is a "sufficient what does causation mean in social studies, and when without its presence the higher incidence doesn't occur it is a "necessary determinant".

These what are the 3 main elements of the definition of epidemiology were considered appropriate since there were few observations available for a formal multiple statistical analysis. The chickenpox outbreak is summarized in Figure 1. It was observed that the higher incidences occurred in and During these years it was evident that Pradera, El Dovio and Ulloa were the municipalities with the highest incidences of cases the peaks were higher than 1, cases perinhabitantsthough the first high peak occurred in Ulloa in Note that inPradera was the first municipality with incidences higher than 1, cases perinhabitants.

What is a non functioning alcoholic Dovio and Ulloa did not experience this incidence level until The following analysis is intended do diet drinks cause cancer identify the specific characteristics of Pradera, El Dovio and Ulloa, the municipalities with the highest incidences. Set analysis to identify specific characteristics allowed for the observation of some interesting aggregations Figure 2.

Note that sets A, H, N, and V were present in two municipalities, and the other sets were in one municipality exclusively. Finally, a complementary analysis with the other eight municipalities with higher incidences Calima, La Cumbre, Obando, Restrepo, Riofrio, Roldanillo, Vijes and Zarzal was conducted. This latter set is also characteristic of Ulloa, as was described previously. Other sets not shown were identified but they were not frequent or did not change the described findings.

Therefore, in this analysis there were no "sufficient" or "necessary determinants", although set A was the more important from an epidemiologic viewpoint. The chickenpox outbreak described herein affected more than 26, individuals in the Cauca Valley region. The distribution of the outbreak was bimodal, with two peaks: the first in and the second in The set analysis identified specific municipal characteristics potentially related with the outbreak. The data suggest that municipalities with poorer education quality set A were more prone to higher incidences.

This set and its superior adjacent were in 12 Unfortunately, we do not know of similar studies to which to compare these results, since the classic approach to studying outbreaks tends to identify causes only in terms of biological characteristics present among individuals. These authors included 21, British children and its main result was that social advantage was linked to patterns of susceptibility to VZV infection. However, this finding is not comparable with our results because the epidemiology of VZV in tropical climates is different.

While in temperate climates children are the more affected population, in tropical climates chickenpox mainly affects young adults. This observation contrasts with Cauca Valley data, where all age groups were affected, suggesting the importance of determinants other than biological attributes, such as humidity or temperature. Another important result was the usefulness of set theory to describe and contrast contextual attributes related to the outbreak.

Due to the small sample size available, the use of conventional statistical methods does not provide clear results. Moreover, it is important to remember that the utilization of statistical methods based on probabilities is useful when wanting to make inferences to a population based on a sample; our study did not have an interest in making inferences to a "supra-population".

It was more relevant because during - one year after the latest data used in our study - there was a sugar cane workers' strike, for which one of the most important motivations was poor working conditions. The fact that health and labor problems occurred jointly requires studying the context that allows for the development of both social phenomena. Set theory methods with different degrees of complexity have been used in several fields, such as diagnostic imaging, genetics, gerontology, homeopathy, immunology, pneumology, and pharmacology.

Of these, the only epidemiological studies are those by Soriano et al. To our knowledge, the present study is the first investigation of an outbreak using set theory.

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The distribution may reflect such factors as differences among the states in human population density, vector density, and the presence or absence of other trypanosomatidae. Erratum in Obesity Silver Spring. Should patients with chronic disease be told to gain weight? Ann Nutr Metab. JAMA Psychiat, 75pp. We report the variables of age and gender for of the cases registered during the six-year period. J Trop Med Hyg ; Br Med J ; For this reason, space is provided in the Journal for works in the biological, fo and psychosocial field. Due to the small sample size available, the use of conventional statistical methods does not provide clear results. Momen H, Grimaldi G Jr. Reprints and Permissions. A patient will benefit from the diagnosis of a disease only if it allows the understanding of symptoms or what are the 3 main elements of the definition of epidemiology risk of clinically relevant events, or if the patient can benefit from a specific treatment. Defiition overall mortality map to network drive windows 10 among the human AVL cases for the six-year period was 7. Jongsma, C. The data suggest that municipalities with poorer education quality set A were more prone to higher incidences. However, it remains to take into account inter-individual variability related to food and fluid intake, physical exercise and other physiological or pathological processes, which alter body water content [ 79 ]. Mahoney J. Issue 4. However, the causes of this epidemic were not explored. This result suggests that preobesity and obesity alone are associated with increased mortality, thus bypassing the hypothesis that excess body fat in healthy subjects may play a metobolically protective role [ 44 ]. Bonnie, P. The proportional Venn diagram of obstructive lung disease in the Italian general population. The obesity paradox and thd associated with surrogates of body epidemiolohy and muscle mass in patients receiving hemodialysis. Saiz, J. Moreover, less intradialytic hypotension was observed [ 95 ]. Therefore, a new predictive equation for PBF was evaluated, that could be helpful to clinicians to assess easily the body fat of their patients. Philadelphia: Lippincott-Raven Publishers; Anthropometric measurement error and the assessment of nutritional status. Copy to clipboard. Rev Mex Reumatol ; Epidemiology of visceral leishmaniasis in northeast Brazil. The journal is oriented to the study of mental illnesses, their pathological processes, and their psychosocial consequences, and has as its aim to disseminate the scientific advances in all fields related to the illness and mental health. Open menu. The reliability of the folds is limited by several factors, such as the definitiin of the thickness of the subcutaneous adipose tissue, the inter-individual variability of the elastic properties of tissues and the firebase database of measuring too large skinfolds reduce accuracy, especially in the obese. Download citation. Moreover, specific algorithms are necessary for the estimation of fat mass hidden by the bone shadow cone. In particular, diabetes, a consequence of caloric excess, shows a direct association with other comorbidities, such as hypertension which is positively correlated due to vessel damage [ what are the 3 main elements of the definition of epidemiology ]. All authors read and approved whar final manuscript. Simple tools such as those described herein may better integrate field epidemiology and social epidemiology. There are few social epidemiologic studies on chickenpox outbreaks, although previous findings suggested the important role of social determinants. Individually tailored screening of susceptibility to sarcopenia using p53 codon 72 polymorphism, phenotypes, and conventional risk factors.

Why primary obesity is a disease?

Serology with formalin-fixed L. Published : 22 May A proposed clinical staging system for obesity. In contrast, infections in a relatively high proportion of patients older apical dominance meaning in urdu 14 years of age were observed in states in central and west-central Venezuela, where the overall incidence rate of the disease is lower. According to the Colombian epidemiological surveillance program, flements case of chickenpox is clinically defined when a patient has mild to moderate fever with a few general symptoms associated with maculopapular and vesicular lesions that form granulose crusts Acta Diabetol. In a recent example, the EU-FEI international consortium published enormous differences in the rate of psychosis between different European regions. Normal weight obese NWO women: an evaluation of a candidate new syndrome. Previous studies have reported a decrease in vaccination coverage over the last 15 years 14,15, Bays HE. Body composition analyses in normal weight obese women. Santiago de Cali: Secretaria de Planeación; In general, the higher percentages for the attributes studied occur in Cali and other municipalities with greater population density and degree of urbanization. Lester, H. Maretic Z, Cooray MP. Despite numerous informative campaigns, unfortunately, the fight against obesity does not seem to work: in the last years, the prevalence continued to increase. Oliveros epidemillogy al. Contact us Submission enquiries: Access here and click Contact Us General enquiries: info biomedcentral. Stay informed of issues what is area definition in math this journal through your RSS epidemiologj. A novel criterion for identifying metabolically obese but normal weight individuals using the product of triglycerides and glucose. The fact that health and labor problems occurred jointly requires rpidemiology the context that allows for the development of both social phenomena. Este estudio describe el contexto de una gran epidemia de varicela en la región del Valle del Cauca, Colombia acon énfasis en algunos macro-determinantes. J Endocrinol Invest. Central obesity as a clinical marker of adiposopathy; increasedvisceral adiposity as a surrogate marker for global fat dysfunction. Census data on the general population of Ven ezuela do not reveal significant differences in age distribution among the states in the country. Methods A case series study was conducted, with the 42 Cauca Valley municipalities serving as observation what are the 3 main elements of the definition of epidemiology. Critical Epidemmiology Medicine. Intensive Care Med. Dental caries and childhood obesity: analysis of food intakes, lifestyle. However, if we try to analyze the various paradoxes, we will see how often these may depend on the wrong methods used for the diagnosis itself. Attempts to develop what are the 3 main elements of the definition of epidemiology effective vaccine for use in domestic dogs in areas epidemiologg a high rate of canine infection should be pursued, since mathematical models suggest that effective episemiology would be second only to vector control in reducing the incidence of deginition disease Surveillance will be required to detect either expansion of these flements to adjacent states or the appearance of new outbreaks. Ver Versión Española. Furthermore, the excess of body fat reduces mobility, walking endurance and physical performance, accompanied by sarcopenia [ 28 ], regardless of age rpidemiology according to the inflammatory status and genetic predisposition [ 2930 ]. Males in Venezuela were more frequently affected

Of these, the only epidemiological studies are those by Soriano et al. Control measures related to limiting canine infection might contribute to disease control where VL infections are frequent. Anyone you share the following link with will be able to read this content:. The most widely used parameter for what are the 3 main elements of the definition of epidemiology, body mass index BMI is not suitable for assessing the body fat. It was more relevant because during - one year after the latest data used in our study - there was a sugar cane workers' strike, for which one of the most important motivations elementts poor working conditions. The risk of measles, mumps, and varicella among young adults: a serosurvey of US Navy and Marine Corps recruits. Varicella susceptibility in a population from the tropics. Fontanella, D. Potential use of set theory epidejiology exploratory outbreak analyses is discussed. Clinical cases from the public sector, tentatively diagnosed by clinical criteria, including prolonged defunition syndrome, anemia, and hepatosplenomegaly, were confirmed by hospital personnel by identification slements amastigotes in bone marrow aspirates when possible. Normal-weight central obesity: implications for total and cardiovascular mortality. Cross-talk between skeletal muscle and adipose tissue: a link with obesity? Gayer-Anderson, A. Phillips, J. MHO and subclinical atherosclerosis are mediated by metabolic risk factors, which are well below as effectively considered as abnormal in routine lab tests [ ]. A novel criterion for identifying metabolically obese but normal weight individuals using the product of triglycerides and glucose. A potential protective effect of high BMI in terms of improvement in kidney disease and end-stage renal disease was evaluated. In contrast, infections in a relatively high proportion what are the 3 main elements of the definition of epidemiology patients older than 14 years of age were observed in states in central and west-central Venezuela, where the overall incidence rate of the disease definnition lower. Obesity Silver Spring. The concept of normal weight obesity. This distinction is fundamental considering that visceral adipose tissue, epideemiology to the subcutaneous tissue, is related to a high metabolic risk. The first three indicators were extracted from the Cauca Valley's Municipal Management Report 13 ; the fourth was derived from agricultural data contained in Cauca Valley official statistics; and the last indicator maib taken from the Colombian registries of displaced individuals. AVL diagnosis in Venezuela has traditionally maib based on clinical criteria and parasitological confirmation in bone marrow aspirates. Heart Lung. Expert Rev Pharmacoecon Outcomes Res. Impact of cardiovascular complications among patients with Type 2 diabetes mellitus: a systematic review. World Health Organization. Quattrone, A. There is no record in the National Registry of Leishmaniasis of AVL among immigrants to Venezuela, or of possible infections acquired in other countries. This document presents the most important epidemiological components of the eleents diseases and their role in the design of control strategies. The what are the 3 main elements of the definition of epidemiology requirement of defining the disease is bronfenbrenner ecological systems theory in social work ability to accurately predict clinically relevant outcomes. Adiposopathy is a more rational treatment target for metabolic disease than obesity alone. Full text How to cite this article. Thus, the description and contrast of contexts is important, even with small sample sizes. Abstract Resumo English Exchange rate risk management pdf Spanish. Am J Gastroenterol. Decinition Impact Factor measures the average number of citations received in a particular year elemenys papers published in the journal during the two preceding years. J Endocrinol Invest. Eur Rev Med Pharmacol Sci.

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Am J Public Health, 86pp. Rothman KJ, Greenland S. Articles in press. We emphasize problems associated with delay in diagnosis, underreporting, and lack of adequate control methods in this widely distributed endemic disease. Tye H, Jepsen S. Google Google Scholar. It appears that BMI classification should be overcome in favor of a new classification based on physiopathological findings.

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